布氏杆菌脊柱炎患者临床特征及影像学表现  

Clinical characteristics and imaging findings of patients with brucella spondylitis

作　　者：杨文强[1,2] 陈静[3] 盛杰 闫怡[1,2] 马海梅[2] 刘玉梅[1] 李斌 张春桃[2] 张韬[1] 马秀敏[1,2] YANG Wenqiang;CHEN Jing;SHENG Jie;YAN Yi;MA Haimei;LIU Yumei;LI Bin;ZHANG Chuntao;ZHANG Tao;MA Xiumin(State Key Laboratory of Pathogenesis,Prevention,Treatment of Central Asian High Incidence Diseases,The First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China;College of Basic Medicine of Xinjiang Medical University,Urumqi 830011,China;Department of Joint and Sports Medicine,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830011,China;Department of Orthopedics,Chest Hospital,Xinjiang Uyghur Autonmous Regin,Urumqi 830049,China)

机构地区：[1]新疆医科大学第一附属医院,省部共建中亚高发病成因与防治国家重点实验室,乌鲁木齐830054 [2]新疆医科大学基础医学院,乌鲁木齐830011 [3]新疆维吾尔自治区人民医院关节与运动医学科,乌鲁木齐830001 [4]新疆维吾尔自治区胸科医院骨科,乌鲁木齐830049

出　　处：《新疆医科大学学报》2018年第12期1480-1484,共5页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2016D01C163)

摘　　要：目的分析布氏杆菌脊柱炎患者临床特征及影像学表现,以提高该病的诊断水平。方法回顾性分析2015-2017年乌鲁木齐市3所医院诊断明确的72例布氏杆菌脊柱炎患者流行病学特征、临床表现、实验室检查、影像学表现。结果 72例布氏杆菌脊柱炎患者,发病年龄以40～59岁为主,占52.78%(38/72);感染途径以牛羊接触史为主,占63.89%(46/72);临床表现主要有发热(45.83%)、多汗(34.72%)、乏力(33.33%)及脊柱区明显压痛及叩击痛等症状;实验室检查中C-反应蛋白升高47例(65.28%),血沉升高32例(44.44%),谷丙转氨酶升高37例(51.39%);影像学检查中MRI在骨质破坏、椎旁脓肿形成、硬膜外脓肿及椎间盘破坏显示出来的影像比DR、CT更具有诊断优势。结论布氏杆菌脊柱炎临床表现多种多样,诊断复杂,误诊率较高。通过对流行病学特点、实验室检查以及DR、CT、MRI 3种影像学特点进行综合分析,对提高该病的确诊率具有重要意义。Objective To analyze the clinical features and imaging findings of patients with Brucella spondylitis in order to improve the diagnosis of this disease.Methods The epidemiological characteristics,clinical manifestations,laboratory tests and imaging findings of72patients with brucella spondylitis diagnosed in3hospitals in Urumqi from2015to2017were retrospectively analyzed.Results In72patients with brucellosis spondylitis,the age of onset was52.78%(38/72),which was mainly from40to59years old.The infection route was mainly cattle and sheep contact history,accounting for63.89%(46/72).The clinical manifestations were mainly fever(45.83%),sweating(34.72%),fatigue(33.33%)and obvious tenderness and snoring pain in the spinal region;C-reactive protein increased in laboratory tests47case(65.28%),erythrocyte sedimentation rate increased in32cases(44.44%),alanine aminotransferase increased in37cases(51.39%);MRI in imaging examination of bone destruction,paraspinal abscess formation,epidural abscess and disc destruction The displayed image has more diagnostic advantages than DR and CT.Conclusion The clinical manifestations of Brucella spondylitis are diverse,the diagnosis is complicated,and the rate of misdiagnosis is high.Through the comprehensive analysis of epidemiological characteristics,laboratory tests and three imaging features of DR,CT and MRI,it is of great significance to improve the diagnosis rate of the disease.

关 键 词：布氏杆菌脊柱炎 临床特征 影像学表现 

分 类 号：R681.5[医药卫生—骨科学]